Information Collection Request

Strategic Prevention Framework for Prescription Drugs (SPF-Rx)

ICR 202005-0930-001 · OMB 0930-0377 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form Grantee-Level Inte Grantee-Level Interview Form and Instruction New Repair queued
Form Annual Implementat Annual Implementation Instrument Form and Instruction New Repair queued
Form Community-Level Ou Community-Level Outcomes Form and Instruction New Available
Form Grantee-Level Outc Grantee-Level Outcomes Module Form and Instruction New Repair queued
Form Evaluation Plan Evaluation Plan Form and Instruction Removed Missing upstream
Form Grantee-Level Inte Grantee-Level Interview Form and Instruction Removed Repair queued
Form Annual Implementat Annual Implementation Instrument Form and Instruction Removed Missing upstream
Form Substitue Data Req Substitue Data Request Form Form and Instruction Removed Repair queued
Form Community-Level Ou Community-Level Outcomes Module Form and Instruction Removed Repair queued
Form Grantee-Level Outc Grantee-Level Outcomes Module Form and Instruction Removed Repair queued
SPF-Rx OMB Supporting Statement_A_5.12.2020.docx Supporting Statement A Uploaded 2020-05-12 Repair queued
Attachment 5_SPF-Rx Summary of Changes to the OMB Pkg_11.21.2019.docx Supplementary Document Uploaded 2020-05-11 Repair queued
SPF-Rx OMB Supporting Statement_B_11.21.2019.docx Supporting Statement B Uploaded 2020-05-06 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
241788 Grantee-Level Interview Form and Instruction New
241787 Annual Implementation Instrument Form and Instruction New
241773 Community-Level Outcomes Form and Instruction New
241772 Grantee-Level Outcomes Module Form and Instruction New
227233 Evaluation Plan Form and Instruction Removed
227232 Grantee-Level Interview Form and Instruction Removed
227231 Annual Implementation Instrument Form and Instruction Removed
227230 Substitue Data Request Form Form and Instruction Removed
227229 Community-Level Outcomes Module Form and Instruction Removed
227224 Grantee-Level Outcomes Module Form and Instruction Removed

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
36 Months From Approved 01/31/2021
321 204
1,869 618
0 0





Reginfo record details
4
table that charts list of burden
IC Title Form No. Form Name
Grantee-Level Outcomes Module Grantee-Level Outcomes Grantee-Level Outcomes
Grantee-Level Outcomes Module Grantee-Level Outcomes Grantee-Level Outcomes
Annual Implementation Instrument Annual Implementation Instrument Annual Implementation Instrument
Community-Level Outcomes Community-Level Outcomes Community-Level Outcomes
Community-Level Outcomes Module Community-Level Outcomes Community-Level Outcomes
Substitue Data Request Form Substitue Data Request Form Substitue Data Request Form
Annual Implementation Instrument Annual Implementation Instrument Annual Implementation Instrument
Grantee-Level Interview Grantee-Level Interview Grantee-Level Interview
Grantee-Level Interview Grantee-Level Interview Grantee-Level Interview
Evaluation Plan Evaluation Plan Evaluation Plan

table that charts list of burden
  Total Request Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 321 204 0 321 -204 0
Annual Time Burden (Hours) 1,869 618 0 1,869 -618 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No